Bariatric reduction system - BARS: device, technique and first clinical experience.

Autor: Di Lorenzo N; PhD program on Applied Medico-Surgical Sciences, Department of General Surgery, University of Tor Vergata, Rome, Italy.; Fondazione Salus, Avezzano, Italy., Camperchioli I; PhD program on Applied Medico-Surgical Sciences, Department of General Surgery, University of Tor Vergata, Rome, Italy., Scozzarro A; PhD program on Applied Medico-Surgical Sciences, Department of General Surgery, University of Tor Vergata, Rome, Italy., Grossi C; PhD program on Applied Medico-Surgical Sciences, Department of General Surgery, University of Tor Vergata, Rome, Italy., Altorio F; Fondazione Salus, Avezzano, Italy., Caputo A; Ovesco Endoscopy AG, Tuebingen, Germany., Gottwald T; Ovesco Endoscopy AG, Tuebingen, Germany., Schurr MO; Ovesco Endoscopy AG, Tuebingen, Germany.; IHCI-Institute, Steinbeis University Berlin, Tuebingen, Germany.
Jazyk: angličtina
Zdroj: Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy [Minim Invasive Ther Allied Technol] 2021 Aug; Vol. 30 (4), pp. 187-194. Date of Electronic Publication: 2020 Feb 26.
DOI: 10.1080/13645706.2020.1729206
Abstrakt: Background: Roux-en-Y gastric by-pass (RYGB) is one of the most effective bariatric procedures, but the rate of weight regain (WR) can reach 63% after the second year. Enlargement of the gastrojejunal anastomosis is one of the reported causes. A newly CE-marked flexible endoscopic system, Bariatric Anastomotic Reduction System (BARS) (Ovesco Endoscopy, Tuebingen, Germany), derivative of the well-established endoscopic over-the-scope-clip (OTSC) clipping system, has been recently developed. It was tested in pre-clinical and preliminary clinical use for feasibility and effectiveness in bariatric anastomotic reduction.
Material and Methods: Using a single-channel endoscope with external supplemental working channel, the BARS device captures the two limbs of the anastomosis, reducing its size, thus slowing food passage. After preclinical assessment, six patients with at least a 15% WR and the presence of an enlarged gastrojejunostomy > 20 mm were enrolled. The mean patient age was 49 years (range 24-67). Average interval between gastric bypass and BARS procedure: 8 years (4-13).
Results: All procedures were safely performed without complications. Mean procedure time: 52 min (37 - 75). Preliminary results: mean weight loss 6 kg (4-9) at a 3-month FU.
Conclusions: BARS could be a promising endoscopic system in case of WR after gastric bypass due to enlargement of the anastomosis.
Databáze: MEDLINE
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